Either I’m missing something, or one of the meanest pieces of proposed legislation is coming down the pike. The proposed bill would require every Minnesota resident to have health insurance while simultaneously mandating Minnesota insurers to offer said insurance, regardless of “age, gender, or health history.”
On the surface this sounds like a reasonable idea—if everyone has health insurance, everyone’s healthcare costs should come down (they won’t). The elephant in the room that no one talks about is cost. How much does this coverage cost an individual with, say, pre-existing heart disease? Minnesota already has a high-risk health insurance pool which has soaked my wife and me mightily with premiums that are now higher than our mortgage.
Basic healthcare is a human right. Until we can collectively agree on that—and we will, it’s just a matter of time—here’s a simple solution: all citizens are placed in a single pool. Insurers are allowed to bid, blindly, on providing insurance to a percentage of that pool. No qualifications; no rejections; no excuses. Premiums are set on a sliding scale based on some sort of formula of income and net worth. Insurance is a crap shoot and it’s high time we put the house advantage in the hands of the citizenry instead of the insurers. Like I said, maybe I’m missing something and that’s what this bill’s sponsors have in mind. But somehow I don’t think so; it doesn’t pass the smell test.
Minnesotans, according to Senator Sheila Kiscaden (I-Rochester; that’s not Independent, that’s Independence Party), sponsor of the bill, “might be required to offer proof of coverage when they filed their income taxes or applied for a driver’s license.” The bill also includes provisions for banning workplace smoking (including restaurants and bars) and would add US$1 per pack to the state’s cigarette tax.
There’s an interesting sidebar in this little soap opera: the bill was really authored by the Minnesota Medical Association. An organization the StarTribune manages to mention but fails to identify. So what’s the Minnesota Medical Association? It’s a trade association for doctors, residents, and medical students - that’s right lobbyists. Yeah boy, I want the doctors’ lobby cooking up mandatory health insurance legislation.
Update 7:20PM CST: Here’s the Senate version of the bill as introduced by Senator Kiscaden. I haven’t read the whole bill, but Subdivision 4 of Section 1 of Article 3 states that the premium can’t be based on pre-existing conditions:
Subd. 4. [COMMUNITY RATING.] (a) The premium rate for the essential benefit set must not vary based upon age, health history, or status, whether coverage is group or individual, gender, geographic location, purchase of additional coverage, or any other factor except as permitted under paragraph (b).
(b) Premium rates for the essential benefit set may vary to reflect actuarially valid differences attributable to nonuse of tobacco, compliance with recommended health screenings and preventive care, or other health-promoting behaviors. Premium rate variations must be approved by the commissioner prior to their use.
(c) Paragraphs (a) and (b) do not apply to optional coverage provided as an addition to the essential benefit set.
That’s good, and it seems reasonable to allow higher premiums for smokers and compliance with health screenings and preventive care. The “other health-promoting behaviors” language is frightening, and will hopefully be removed from the final version.
More disturbing is the fact that the “essential benefit set” isn’t defined and will be determined by an “expert advisory committee” composed of, you guessed it, “physicians, researchers, actuaries, human resources professionals, medical educators, quality improvement professionals, and other persons with expertise….”
Thanks so much for that. I’ll sleep better at night knowing that these folks will be mandating my insurance benefits. Actually, these are exactly the folks I want deciding what gets covered. Apologies and genuflections.
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